Summer 2019 State of the State

Key legislation Affecting the healthcare community

Jon Amores, Director of Government RelationsRick Hazelton, Deputy Director of Government Relations

Arizona Medical Association(602) 799-2043

2019 Legislative Session Overview• 1318 Bills Introduced• ArMA tracked 208 bills with a healthcare focus• 135 Days of Session• Adjourned sine die on May 28th at 12:58am• 321 Chaptered Bills• 11 Vetoed Bills• One resignation (Rep. Stringer)• $11.8 billion-dollar budget

2019 Legislative Session OverviewThe Arizona Medical Association

ArMA’s 2019 Legislative Priorities:•Reversing the Opioid Epidemic• Strengthening Public Health• Expanding Access to Care for Arizonans•Administrative Simplification for Physicians and Patients

The Budget•Physician Shortage / Graduate Medical Education Programs: $5,524,400 in

state general funds in FY 2019-2020 to supplement graduate medical education programs in rural counties, and $4,419,300 for urban areas; $8 million to U of A Phoenix Medical School

•KidsCare: $1,586,900 from general fund to prevent enrollment freeze•Maternal Morbidity and Mortality Prevention: $1.7 million in FY 2019-2020

to DHS to provide primary care-based programs in rural areas for physicians and mid-level providers for prenatal care, including sonogram and telemedicine equipment for rural hospitals; $500,000 in FY 2020-2022 to DHS for student loan repayment options for healthcare professionals who provide prenatal care in healthcare professional shortage areas

•Trauma Funds: $1.5 million for critical access hospital services in Benson and Willcox

Reversing the Opioid

Reversing the Opioid EpidemicHB 2075/SB 1108: electronic prescribing; exceptions; deadlines• Delays implementation of EPCS until January 2020• Eliminates waiver process• Restores PA's ability to prescribe specified substances

SB 1029: qualifying physicians; opioid-dependent patients• Allows the Medical and Osteopathic Boards to determine whether a

licensed physician has the training to treat and manage opioid-dependent patients pursuant to federal law

Strengthening Public Health

Public Health LegislationHB 2318: texting while driving; prohibition; enforcement: Primary offense; exemptions: 1) stopped vehicle, and 2) hands-free texting or navigation

Vaping Legislation: SBs 1009, 1060, 1147 & HB 2357• County / city / school preemption• Bills did not pass

Immunization Legislation: Six bills stopped!• HB 2470/SB 1114: schools; immunization; religious exemption• HB 2471/SB 1115: informed consent; vaccinations• HB 2472/SB 1116: vaccinations; antibody titer testing; notification

Public Health Legislation• HB 2550: regulation; kratom productsEstablishes requirements and prohibitions related to the preparation, distribution, sale and exposure of kratom products; prohibits sale to minors

• SB 1468: schools; suicide prevention trainingRequires school districts, charter schools, and AZ teacher training programs to include suicide awareness and prevention training and directs AHCCCS to make suicide awareness and prevention training available

Access to Care Legislation

Access to Care LegislationSB 1089: insurance; telemedicine• Requires insurers to provide coverage for any health care services that are provided

through telemedicine, if the health care service would be covered were it provided in-person

SB 1085: association health plans; definitions; requirements• Revises and establishes requirements for association health plans

Other Healthcare Legislation

Insurance-Related LegislationHB 2494: health insurers; notice; providers• Provides payment and notification requirements for health insurers and

health providers

SB 1100: insurance; living organ donors• Prohibits insurers from discriminating against a living organ donor based on

the person's status as a living organ donor

HB 2166: insurance; cost-sharing; calculation• Requires a healthcare insurer to include any cost sharing amount paid by

either the enrollee or another person on behalf of the enrollee when calculating an enrollee's contribution to any out-of-pocket maximum, deductible, copayment, coinsurance or other applicable cost sharing

Regulatory LegislationAdministrative Simplification

HB 2569: occupational licensing; reciprocity– Allows a person who has held an out-of-state occupational license for at least one year to

practice their profession in Arizona if they abide by the outlined stipulations, including being a current certified or licensed professional in good standing, and do not have any pending complaints, allegations or investigations relating to unprofessional conduct.

– Law will affect industries that require a license to operate, including health care professions, teaching, accounting and engineering.

SB 1105: direct primary care agreements– Creates framework for direct primary care agreements; not an insurance product

SB 1086: health professions; temporary licensure– Establishes the process and requirements for obtaining a temporary license from an Arizona

health profession regulatory board

Scope of Practice Legislation

• HB 2548: pharmacists; prescribing authorityBill did not make it out of House• HB 2068: clinical nurse specialists; prescribing authorityGrants prescription privileges to a CNS if certain criteria are met; prohibits a CNS from prescribing opioids or benzodiazepines to be used or filled outside of a licensed health care facility, unless prescription is written pursuant to discharge protocols of the institution

Universal Coverage – Almost There – 6.5% Uninsured RateState Backed insurance Option – Health Care Cost Savings ActHospital Prices - HB1004Reduce Out of Pocket Costs – HB1174 Drive Down Cost of Insurance – HB 1168Lower RX Costs: Colorado Wholesale Importation of Prescription Drugs Act

FailedImprove Vaccination Rates

Contrast Colorado – The Polis PrimaveraRoadmap for Saving Money on Healthcare

HB 1168 Addresses

• High Premiums• Competition• Rural Access

Impact250K residents

Needs $120M state funding

Hospital FundingChanged to Include• Limit on Hospital Fees• Hospital Exemptions

PASSED State will submit federal waiver